Association Between Time to Rehabilitation and Outcomes After Traumatic Spinal Cord Injury

Kurt R. Herzer, Yuying Chen, Allen W. Heinemann, Marlis Gonzalez Fernandez

Research output: Contribution to journalArticle

Abstract

Objective: To examine the relations between time to rehabilitation after spinal cord injury (SCI) and rehabilitation outcomes at discharge and 1-year postinjury. Design: Retrospective cohort study. Setting: Facilities designated as Spinal Cord Injury Model Systems. Participants: Patients (N=3937) experiencing traumatic SCI between 2000 and 2014, who were 18 years or older, and who were admitted to a model system within 24 hours of injury. Interventions: Not applicable. Main Outcome Measures: Rasch-transformed FIM motor score at discharge and 1-year postinjury, discharge to a private residence, and the Craig Handicap Assessment and Reporting Technique (CHART) Physical Independence and Mobility scores at 1-year postinjury. Results: After accounting for health status, a 10% increase in time to rehabilitation was associated with a 1.50 lower FIM motor score at discharge (95% confidence interval [CI], -2.43 to -0.58; . P=.001) and a 3.92 lower CHART Physical Independence score at 1-year postinjury (95% CI, -7.66 to -0.19; . P=.04). Compared to the mean FIM motor score (37.5) and mean CHART Physical Independence score (74.7), the above-mentioned values represent relative declines of 4.0% and 5.3%, respectively. There was no association between time to rehabilitation and discharge to a private residence, 1-year FIM motor score, or the CHART mobility score. Conclusions: Earlier rehabilitation after traumatic SCI may improve patients' functional status at discharge.

Original languageEnglish (US)
JournalArchives of Physical Medicine and Rehabilitation
DOIs
StateAccepted/In press - 2016

Keywords

  • Models, econometric
  • Outcome assessment (health care)
  • Rehabilitation
  • Spinal cord injuries

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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